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Anthropometric data of 1441 children under five years of age participating in a prospective study in a displaced community in the Sudan were examined to determine the causal association between protein‐energy malnutrition (PEM) and diarrhea. Poor nutritional status was defined as scoring less than minus two standard deviations in any of the three anthropometric indices, weight for age (W/ A), weight for height (W/H), and height for age (H/A). Waterlow classification was also used (cutoff points at minus 2 standard deviation scores). Different anthropometric indices showed different results. Only boys in their second year of life with W/H and H/A < — 2SD scores showed significant associations between PEM and diarrhea. Girls showed a complex set of associations. Waterlow classification did not show any association except for wasted boys less than one year and girls in their third year of life. We conclude that PEM measured by the currently used anthropometric indices is not a risk factor for diarrhea in children under five years of age.
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